A Anomalous origin of the left coronary artery from the pulmonary trunk B Asymmetric hypertrophy of the ventricular septum with myocyte disarray histologically C Concentric thickening of ventricular myocardium. Histologically, translucent refractile material between monocytes which stains with Congo Red D Coronary artery stenosis. Histologically the plaque has a thick fibrous cap and a lipid-rich core E Coronary artery stenosis. Histologically the plaque has a thin fibrous cap which has ruptured and there is overlying thrombus F Dysplastic pulmonary valve leaflets with restricted valve opening G Elongation of chordae tendinae and mitral valve leaflets. Histologically, myxomatous degeneration of these tissues H Enlarged left ventricular with reduced wall thickness. Histologically cardiac fibrosis, patchy myocyte hypertrophy and low grade chronic inflammatory infiltrate I Fibrofatty replacement of the right ventricular myocardium, with aneurysm formation J Morphologically and histologically normal heart, but at molecular level, abnormality of ion channel function K No gross pathological abnormality, but histologically fibrous replacement of the conducting system L Thickened bicuspid aortic valve with restricted opening For each of the following case histories, which is the most likely underlying cardiac pathology? 1. A 23-year-old man complains of recurrent exertional syncope and breathlessness. He has a jerky pulse, a double apical impulse and an ejection systolic murmur at the left sternal edge which is a louder on standing. 2. A 35-year-old woman complains of frequent awareness of â€˜missed beatsâ€™. Cardiac auscultation reveals multiple mid systolic ? and a late systolic murmur. 3. A 16-year-old previously fit boy dies suddenly. His father has a history of recurrent syncope. The fatherâ€™s ECGs showed PR interval 0.14 secs, QRS duration 0.1 sec and corrected QT interval 0.48 seconds. 4. A 53-year-old man presents with a one day history of episodes of retrosternal chest tightness which occurred on minimal exertion or when resting and which lasted for up to half an hour. 5. A 75-year-old lady complains of recurrent syncope. Clinical examination is normal. Ambulatory ECG monitoring reveals sinus pauses of up to four seconds.